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Female Athlete Triad Syndrome
palsojeda; posted:
My teenage daughter changed her diet from lacto/ovo vegetarian to strict vegan about 14 months ago. Her ob/gyn diagnosed her as having female athlete triad, and after a recent bone scan, we discovered that her 't' score is that of a 30-year-old and her 'z' score is -2.8. Could someone please point me to resources that help us understand what this all means? Thank you!
bonebabe responded:
Look at the National Osteoporosis Foundation website ( ) for answers and good reliable information.

Just as a point of interest, teenagers will have low bone density when doing a bone density scan because they haven't reached their peak bone mass yet. As for having the T-score of a 30 year old, that is a misleading statement. The DXA data base is that of a 30 year old and T-scores compare your bone density to that. The Z-score compares her to other girls her age - if they're using a pediatric software program.

If her doctor has ruled out any illnesses or conditions that would raise suspicion about her bone density other than diet, I wouldn't be too concerned at this point. She probably would be well served to take a calcium supplement each day, along with a vitamin D supplement.
Adi Cohen, MD, MHS responded:
Because your daughter is a teenager, it most appropriate to use the Z score, not the T score, when interpreting her bone density results. A Z-score of -2.8 is, by definition, lower than expected for her age. An evaluation for causes of osteoporosis and bone loss could help to better define the type of bone problem she might have and can help to guide future management. Some causes of low bone density in this age group could be treated or corrected leading to an improvement in bone health. If nutritional deficiencies or estrogen deficiency/loss of periods are thought to be contributing to the low bone density, then therapy could be aimed at correcting these problems. Further evaluation could also help to guide recommendations for vitamin use and calcium supplements. Based on one bone density test, it is difficult to know whether your daughter is appropriately gaining bone or even currently losing bone, so a repeat bone density test in 1-2 years will be an important part of the plan, as well.

In addition, the following two resources may be helpful to you and your daughter:

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